Trepanning

By Dr. Michael Echols

Trepanning is the medical process of drilling or cutting a hole into the skull in order to relieve pressure on the brain tissue, lift a compression fracture of the skull, or remove a blood clot on the brain.  If a person had a concussion with depression of the skull bone, that depressed area would need to be lifted or removed and then the clot under the concussion removed to alleviate trauma induced symptoms.

The process is documented to have been performed as far back as 4000 years ago by the Inca Indians of Peru.  If you would like more information on this procedure and the history, please do a search for the words: trephine, Inca, neurosurgery, trepanning, trepan on Google.com.

Trepanning (pronounced: tree-panning), as was frequently practiced in America during the 1800's, was performed with an instrument called a trephine (pronounced: tray-feene or tree-fine) which actually is a saw that cuts a circular hole in the scull.

The scalp over the skull is first incised with a scalpel, a flap laid back, and the hole bored or saw cut by a twisting motion of the trephine.  In some types of trephines, there is a center drill which holds and guides the outer cutting edge of the saw.  There are two main types of trephine saws, the earlier crown type and the later Galt type.

Image: Drawings from Bourgery & Jacob

From: medicalantiques.com

Posted in: Civil War Surgery